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The cost of medication-related problems (MRPs) is staggering. In a landmark study, "Drug-Related Morbidity and Mortality: A Cost-Of-Illness Model", researchers say that the costs of MRPs for ambulatory patients are about $80 billion per year, and for every dollar spent on medications, another dollar is spent to treat new health problems caused by the medications. Approximately $3 billion is spent annually for medications in nursing facilities; therefore, for every dollar spent on medications, $1.33 is spent to treat medication-related problems.  Some estimate the total cost of MRPs exceeds $100 billion annually.

Another study estimates the percentage of hospitalizations of older patients due to adverse medication reactions to be 17%, almost six times greater than for the general population. The effects in older persons are drowsiness, loss of coordination, and confusion. This can result in falls or auto accidents.

Older people are especially at risk for several reasons. First, the physiological changes of aging increase the risk for medication problems. Experts agree that medication effects in older people are often different than in young people. And, as a group, older people are more likely to suffer from multiple chronic diseases, requiring several different medications at one time. The more drugs one takes, the higher the risk for problems with drug interactions. The average older person uses 4.5 prescription medications concurrently and an additional two over-the-counter medications.

Older people use at least 25% of all over-the-counter medications for many common conditions, such as arthritis, insomnia, and pain control. Yet, little information or labeling exists on these remedies to let older people, who want to self-medicate, know how these products may complicate their condition or interact with other medications. A good example is when an older man with an enlarged prostate develops acute urinary retention after taking an antihistamine or a decongestant.

One of the solutions to this enormous problem is to train health care professionals and assist them in becoming more knowledgeable about geriatrics and the clinical use of medications in the elder population. They should have special instruction about this age group, beginning in school and throughout their careers. Increased knowlege and understanding will be invaluable in providing better care, creating better outcomes, and controlling health care costs of the elderly. If your pharmacist is a Certified Geriatric Pharmacist, he or she has the knowledge and  skills necessary to advise you.